What are your favorite tips to assist patients with pain to sleep better? Physical Therapists work with patients to resolve movement impairments that often are associated with pain and other symptoms. As part of the interventions we provide in our plan of care, we may typically offer some advice on sleep supports, basic pillow positioning and maybe a little input on general sleep hygiene. What if you could offer more in-depth insight and specific information to assist this patient with their suffering? Join NAIOMT on the online course “Sleep Ergonomics: Clinical Applications- Physical Therapy Approaches to Promote Patient Restorative Sleep” to learn more about some of the alternative and best practice ways to assist your patient with sleep related ergonomics and pain.
A recent article by Krause, et al 2019 explores the bidirectional nature of pain and sleep loss in a within subject repeated measure design. This study although involving a small sample of the non-symptomatic population (N=25, 18-30 yr. old, relatively evenly split between males and females) demonstrated that even a brief amount of disruption to a person’s sleep quality in particular (15 minutes or more), can have profound effects on their pain sensitivity and experience of pain. Using quantitative sensory testing (skin thermal/hot sensitivity) amongst other tests, these individuals were analyzed during and following a single night sleep rested and a single night sleep deprived state, with these test days separated by at least 7 days.
We know scientifically that sleep deprivation (quality and quantity) enhances pain responsivity within the primary sensing regions of the central nervous system and simultaneously reduces activity in pain modulating (ie. pain inhibition) areas of the brain including the striatum and insula. Just imagine what can happen in this pain excitatory and loss of inhibitory controls state for a patient with persistent or acute pain!
As a Physical Therapist, it is then encouraging to know that even with a small improvement in sleep quality, in particular, we can have a profound influence on a patient’s neurosensory response to and sensitivity to pain. Sign up for the NAIOMT course to learn how to make that happen in collaboration with your patients!
Krause AJ, et al. The Pain of Sleep Loss: A Brain Characterization in Humans. J Neurosci. 2019. Mar 20;39(12):2291-2300